Pulse oximeters 'more effective' in COVID-19 screening for older adults: New Study

Pulse Oximeter can help screen lower oxygen saturation levels and eventually identify asymptomatic COVID-19 patients much more effectively in the elderly than routine temperature checks, a new study published in the journal Frontiers in Medicine on Tuesday has found. While the patients are much more accustomed to high temperature as a key indicator of the novel coronavirus infection, researchers at the Washington State University stressed that the efficacy of symptom-based screening [temperature and self-report] for COVID-19 has been called into question. 

As the pandemic hit, the older adults have been more vulnerable to contracting the Severe Acute Respiratory Syndrome (SARS-CoV-2), making up about 45 to 80 per cent of the total hospitalization. While the presence of fever is a key clinical indicator of infection and inflammation, the symptom-based screening, in most cases, might not diagnose the severity of the infection. “98 per cent of the COVID-19 patients were found to have a fever, however, studies have found that older adults show a lower core body temperature, described as below 98.6°F,” the study stressed. In fact, about 30 per cent of older adults with serious coronavirus infection show a mild or no fever, the researchers found. And the delay in seeking health care increases their mortality risk. 

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"Checking SpO2 regularly provides COVID-19 patients reassurance and reduces emergency room visits," according to the new study. 

In April, last year, when the pandemic hit, an emergency room doctor observed many COVID-19 patients without visible signs of dyspnea but had a SpO2 below 90 per cent on the Oximeters, a cause of concern. “These patients had a form of oxygen deprivation, which is difficult to detect, called ‘silent hypoxia,’ despite the patients feeling alert and breathing normally,” researchers purported in the study. They added, that the “asymptomatic hypoxia” (AH) or “silent hypoxia” is becoming more prevalent in the COVID-19, and can be detected with Oximeters. “A higher discrepancy was found between oxygen saturation (SpO2) and respiratory rates in COVID-19 Acute Respiratory Failure,” said the doctors. 

COVID-19 can 'mask' severe hypoxia

“Without a SpO2 measurement, which can be done using a clip-like device oximeter, normal breathing rates could mask severe hypoxia and make the assessment of COVID-19 infection’s severity more difficult in an out-of-hospital setting.” Therefore, the use of a pulse oximeter, a non-invasive and painless device that measures oxygen saturation levels, can detect the presence of hypoxemia in older COVID-19 patients. “Given its potential efficacy for detecting changes in SpO2, pulse oximeters should be considered to screen for COVID-19 AH in older adults,” the researchers suggested. The portable, inexpensive devices can be used at home to measure SpO2 at home and determine the severity of the coronavirus in the lungs even when the older person is asymptomatic. According to the study, “detecting AH is critical for the prevention of infection progression and initiating treatment.”